Psychologists Must Stand by their Ethical Obligations

by J. Wesley Boyd, MD, PhD on August 11, 2014

American psychologists designed and oversaw the brutal regime of interrogation used on detainees in U.S. military custody at Abu Ghraib, Guantánamo Bay, and elsewhere during the U.S. war on terror; but the profession has yet to punish any psychologist who participated in torture or to fully distance itself from this legacy.

The ties between psychologists, the American Psychological Association (APA), and the U.S. military date back at least a century. The APA directly recruited psychologists into military service during both world wars, where they evaluated new recruits, assisted in the treatment of soldiers with “shell shock,” and offered advice about captured enemy soldiers in order to make interrogations more effective. In 1919, the APA elected the army’s highest ranking psychologist as its president. After World War II, the navy established one of the first APA- approved internships. The tradition has continued and today the Department of Defense (DOD) is the single biggest provider of psychology internships in the country. Additionally, 7 percent of all psychologists are employed by the DOD.

After the involvement of psychologists in the CIA’s abusive detention and interrogation practices came to light in 2004, the American Medical Association and the American Psychiatric Association issued statements prohibiting participation in interrogations as a violation of medical ethics. In stark contrast, the APA allowed psychologists to participate in interrogations, including those that meet the definition of torture under international law. This position, which was adopted in 2005 with some secrecy about its drafters, was outlined in the APA’s PENS report. The position outlined in the report remained in effect until 2013, when it was repealed.

But the questions remain: Why did psychologists allow the PENS report – a policy condoning torture and the violation of APA’s own code of ethics – to be passed in the first place? And why did it take eight years to rescind it?

Medical colleagues and I were curious to know what psychology students knew about the ethical responsibilities of military psychologists, so we surveyed 185 students at 20 different graduate programs in clinical psychology. We wanted to find out whether they were aware of their professional obligations during military service, including under the Geneva Conventions – the most widely cited set of international standards.

Through our research, we found that 74 percent of psychology students had received less than one hour of instruction about military medical ethics. Even though 75 percent claimed to be familiar with the Geneva Conventions, the majority gave incorrect answers when tested on specific points. For example:

Only 37 percent could correctly identify that the Geneva Conventions apply irrespective of whether war has formally been declared

43 percent did not know that the Geneva Conventions state that physicians should "treat the sickest first, regardless of nationality”

Half of the students did not know that the Geneva Conventions prohibit ever threatening or demeaning prisoners as well as depriving them of food or water for any length of time

48 percent could not state when they would be required by the Geneva Conventions to disobey an unethical order from a superior

Based on these findings, my co-authors and I surmise that not only do psychology students learn little about the professional standards that constrain unlawful and unethical practices, but they also have a false sense of complacency about their knowledge of such matters. This is a troubling finding, given that psychologists lacking an understanding of their ethical obligations are less prepared to disobey, let alone protest, unethical orders, and are more likely to be compliant when told to assist interrogators in ways that violate international standards.

Although the APA recently annulled the PENS report, it still positions psychologists as adjuncts to national security by allowing them to participate in interrogations under certain circumstances. The Senate’s report on the CIA torture program — whose 500 page executive summary is poised to be released — will likely reveal further details of this complicity. Given the APA’s lack of moral clarity and flouting of international law, it is imperative that psychology students receive more education in military medical ethics in order to prevent a repeat of psychologist participation in abusive interrogations and torture.

The fact that the detention center at Guantánamo ever opened – much less is still in operation and continues to abuse detainees, most recently by force-feeding hunger strikers – will likely go down as one of our country’s most egregious ethical lapses. Psychologists need to be educated about the Geneva Conventions and other international codes of ethics to ensure they do not become pawns of the U.S. military establishment – inadvertently or otherwise.

APA members need to demand that their organization not take positions that are contrary to international law and to ensure that psychologists who have committed crimes in the name of patriotism are held accountable for their actions.

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Submitted byRobert Reifsnyderat03:13 PMonAugust 13, 2014

Thank you for this study and calling out the APA for its position and lack of professional oversight. I and many other psychologists are not members of the APA because this and other positions often do not represent our standards and concerns. Instead, I have long believed that everyone in healthcare and human services should ascribe to the foundational premise and directive of medicine - "Do No Harm".